Document Detail


Associations of urinary levels of kidney injury molecule 1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) with kidney function decline in the Multi-Ethnic Study of Atherosclerosis (MESA).
MedLine Citation:
PMID:  22749388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Whether elevations in levels of urinary biomarkers of tubular injury (urine neutrophil gelatinase-associated lipocalin [NGAL] and kidney injury molecule 1 [KIM-1]) are associated with future risk of kidney disease has not been investigated.
STUDY DESIGN: 1:1 nested case-control study.
SETTING & PARTICIPANTS: 686 participants in the Multi-Ethnic Study of Atherosclerosis (MESA).
PREDICTOR: NGAL and KIM-1 were measured at baseline, expressed as log-transformed continuous variables, and categorized into deciles.
OUTCOMES: Kidney function was estimated by cystatin C level using the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Incident CKD stage 3 was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) and an eGFR decrease >1 mL/min/1.73 m(2) per year, and rapid kidney function decrease was defined as decrease ≥3 mL/min/1.73 m(2) per year.
MEASUREMENTS: Cases were defined as persons with eGFR >60 mL/min/1.73 m(2) who subsequently developed incident CKD stage 3 and/or had rapid kidney function decrease by the MESA year-5 visit. Controls were matched for age, sex, race, diabetes, and baseline eGFR. We adjusted for age, hypertension, and presence of albuminuria (albumin-creatinine ratio ≥30 mg/g).
RESULTS: Of 343 cases, 145 had incident CKD stage 3, 141 had rapid kidney function decrease, and 57 had both. Mean eGFR for controls was 81 ± 10 mL/min/1.73 m(2) at baseline and 80 ± 10 mL/min/1.73 m(2) at follow-up compared with 82 ± 13 and 58 ± 10 mL/min/1.73 m(2) for cases. Each doubling of KIM-1 level (in picograms per milliliter) was associated with an OR of 1.15 (95% CI, 1.02-1.29) for incident CKD stage 3 and/or rapid kidney function decrease. Compared with the lowest 90%, the highest decile of KIM-1 level was associated with an OR of 2.02 (95% CI, 1.15-3.56) for the outcome; these associations were independent of albuminuria. NGAL levels (in nanograms per milliliter) were not associated with incident CKD stage 3 and/or rapid kidney function decrease (OR, 1.04; 95% CI, 0.99-1.10). Results were similar when KIM-1 and NGAL levels were standardized for urine creatinine.
LIMITATIONS: The case-control design limits the ability to account for persons who died or were not available for follow-up.
CONCLUSIONS: Urinary KIM-1 level is associated with future risk of kidney disease independent of albuminuria. Urinary biomarkers of tubular injury are a promising tool for identifying persons at risk of CKD.
Authors:
Carmen A Peralta; Ronit Katz; Joseph V Bonventre; Venkata Sabbisetti; David Siscovick; Mark Sarnak; Michael G Shlipak
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-06-30
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  60     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-12     Completed Date:  2013-01-11     Revised Date:  2013-12-05    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  904-11     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Acute-Phase Proteins / urine*
Aged
Aged, 80 and over
Albuminuria / ethnology,  urine
Atherosclerosis / ethnology*,  urine*
Biological Markers / urine
Case-Control Studies
Ethnic Groups / ethnology
Female
Follow-Up Studies
Humans
Kidney Diseases / ethnology*,  urine*
Lipocalins / urine*
Male
Membrane Glycoproteins / urine*
Middle Aged
Proto-Oncogene Proteins / urine*
Receptors, Virus
Grant Support
ID/Acronym/Agency:
1K23DK082793-01/DK/NIDDK NIH HHS; K23 DK082793/DK/NIDDK NIH HHS; N01-HC-95159/HC/NHLBI NIH HHS; N01-HC-95160/HC/NHLBI NIH HHS; N01-HC-95161/HC/NHLBI NIH HHS; N01-HC-95162/HC/NHLBI NIH HHS; N01-HC-95163/HC/NHLBI NIH HHS; N01-HC-95164/HC/NHLBI NIH HHS; N01-HC-95165/HC/NHLBI NIH HHS; N01-HC-95166/HC/NHLBI NIH HHS; N01-HC-95167/HC/NHLBI NIH HHS; N01-HC-95168/HC/NHLBI NIH HHS; N01-HC-95169/HC/NHLBI NIH HHS; R01 AG027002/AG/NIA NIH HHS; R01 DK072381/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Acute-Phase Proteins; 0/Biological Markers; 0/HAVCR1 protein, human; 0/LCN2 protein, human; 0/Lipocalins; 0/Membrane Glycoproteins; 0/Proto-Oncogene Proteins; 0/Receptors, Virus
Comments/Corrections

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